Provider Demographics
NPI:1184059131
Name:OFFUTT, RESHIL ETE'
Entity type:Individual
Prefix:
First Name:RESHIL
Middle Name:ETE'
Last Name:OFFUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12749 NE 170TH LN
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7945
Mailing Address - Country:US
Mailing Address - Phone:425-444-8670
Mailing Address - Fax:
Practice Address - Street 1:12749 NE 170TH LN
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7945
Practice Address - Country:US
Practice Address - Phone:425-444-8670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst